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UN @tA L , O 819 Striker Ave,Suite 8•Sacramento,CA 95(916)921-9600 ❑ East i 1115 Montgomery,Suite B•Spokane WA 99206 0)924 9200 <br /> ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 S W Sequoia eq a P kwy,Suite 114 Portland,OR 97222 (503)624 9800 <br /> Consultant Company G �N( Project Name r3 to _()> -SA-(v. � <br /> Address 2'-5-sv t7 UNOCAL Project Manager FOUST— <br /> City Ver State <�A Zip Code ` 0 AFE it <br /> Telephone �—oa — J0-0 FAX# Y(-J:M Site#,City, State �� s� CJS � <br /> U <br /> Report To LC— E Sam lerr- /w-%-vp PX' QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A E- <br /> Turnaround 5p'10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnaiyses Re nested a- <br /> Time ❑ 2 Work Das Q 1 Work Day ❑ 2-8 Hours ❑ Waste ate <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure A Other <br /> Client Date rime Matrix #of Cant Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> t 1 NR, 5 13,%1 t000 A J 7zvyAg 61 A 0 <br /> 2 (abs f a2 0 <br /> 0 <br /> 3 � <br /> 4 3 <br /> 0 <br /> 5 <br /> } <br /> fi <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> �n <br /> L <br /> Relinquished By D�-� Time15f(D Received By Dat ime <br /> m <br /> Relinquished By Date Time Date Time <br /> Relinquished f3 ate Time Received B Lab Date 3 V Time ��C7 <br /> Were Samples Received in Good Condition?O Yes a No Samples on Ice? ❑Yes❑ No Meth4f of Shipment Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑ No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />